What Are Nebulizers and Inhalers?

Nebulizers and inhalers turn liquid medicine into a mist so that kids can breathe
it in. Some inhalers release the medicine in a fine powder form that also can be breathed
in.

These tools are effective when used properly. But each have their pros and cons
— so talk to your doctor about which one is best for your child.

How Does a Nebulizer Work?

A nebulizer is an electric or battery-powered machine. It usually has four parts:

the motor

the mouthpiece or facemask

the cup

tubing

Medicine is put into the cup, which is attached to the motor via tubing. The mouthpiece
or facemask is then attached to the cup. When the machine is turned on, it sends a
mist into the mask. The child can breathe in this mist.

Kids don't have to "do" anything to receive the medicine except stay still and
breathe in. It usually takes about 5 or 10 minutes to breathe in all the medicine.
A child who doesn't stay still and cooperate, or who cries, may not get all the medicine
needed. During treatment, it's important to help your child be as still and calm as
possible.

How Does an Inhaler Work?

Metered dose inhalers (MDI)

MDIs push out a pre-measured spray of asthma medicine. They look like mini aerosol
cans. When a person squeezes the inhaler, a measured "puff" of medicine is released.

MDIs require coordination when used on their own. A child must be able to activate
the device and breathe in at the same time. If not, the medicine may end up in the
mouth instead of in the lungs. That's why for younger kids many doctors recommend
attaching the metered dose inhaler to a spacer.

A spacer is a kind of holding chamber for asthma medicine. It attaches to the inhaler
on one end and to a mouthpiece or mask on the other end. When someone pushes down
on the inhaler, the medicine stays in the spacer until he or she is ready to breathe
it in. So, it's possible for very young kids and even babies to take their medicines
using a metered dose inhaler with a spacer because they don't have to "do" anything
other than sit and breathe.

With a spacer, it usually takes less than 30 seconds to get medicine into the lungs.

Some MDIs have counters that indicate how many doses remain. If there's no counter,
the number of doses already used should be tracked so that the inhaler can be replaced
on time.

Dry Powder Inhalers

Dry powder inhalers deliver medicine as a powder. The powder is also breathed in,
but it doesn't spray out. Kids need to do more of the work by inhaling the powdered
medicine quickly and strongly. Most kids can do this when they're around 5 or 6 years
old.

What Else Should I Know?

Using nebulizers or inhalers can be tricky. So ask your doctor to show you how
the device works before you first use it. Doctors might ask an older kid or teen to
demonstrate using an inhaler and offer advice, if needed.

If you have any questions or if you're concerned that your child isn't getting
the right dose of medicine, talk to your doctor.